Inelastic bandages maintain their hemodynamic effectiveness over time despite significant pressure loss

n/

A Case of Treatment Resistant Depression and Alcohol Abuse in a Person with Mental Retardation: Response to Aripiprazole and Fluvoxamine Therapy upon Consideration of a Bipolar Diathesis after Repetitive Failure to Respond to Multiple Antidepressant Trials

Mental Retardation (MR) is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD) and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over) prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions

The feasibility of underwater computerised strain gauge plethysmography and the effects of hydrostatic pressure on the leg venous haemodynamics

Background: Strain gauge plethysmography (SGP) is employed to evaluate venous drainage of the lower leg. Methods: In this study, SGP was used to evaluate the effects of the hydrostatic pressure (HP) of water on venous volume (VV), expelled volume, and ejection fraction (EF) in 22 healthy legs before and during immersion in water. Results: HP reduced VV by 100% and even more during underwater (UW) exercise, making calculation of the UW EF possible. Discussion: UW SGP is feasible and indicates that HP improves venous haemodynamics. This study suggests that including UW leg exercise in the rehabilitation protocols of patients with chronic venous disease may be useful. Keywords: Strain gauge plethysmography, Underwater compression, Underwater ejection fraction, Underwater venous volume. 2020 The Aut

An Innovative Compression System Providing Low, Sustained Resting Pressure and High, Efficient Working Pressure

Chronic venous insufficiency (CVI) can cause considerable morbidity and reduced quality of life. Compression therapy, such as bandages and stockings, is the cornerstone and golden standard in the prevention and treatment of CVI today. It is also shown that compression used after the healing of ulcers, reduces the rate of recurrence. It has been found that compression products with a stiff, non-elastic material, are essential for an improved haemodynamic effect, indicating that low resting pressure and high working pressure is vital, in order to achieve the most effective and well tolerated compression treatment. However, one great challenge is that by applying a stiff bandage, either as a single component or as a part in a multi-component product, one always adds, a not so easily quantified, resting pressure. In order to achieve the most effective treatment it is easy to apply the bandage in a too tight and uneven manner, often resulting in painful resting pressures. In earlier studies, it has been shown that common for todays practice is that the compression treatment is dependent on the applier and that only about 10% of the healthcare personnel managers to apply a pre-defined target bandage pressure. It has also been shown that the applied pressures decrease in effectiveness, only after a couple of hours, due to e.g. oedema reduction, resulting in poor compression treatment over time

Lymphedema and nutrition: A review

Nutrition is considered a basic component in the management of any vascular disease. Lymphedema is characterised by an increase of interstitial fluid due to a lymphatic system morphological and/or functional alteration. Therapeutic management of lymphedema includes a multi-faceted approach based on compression and physiotherapy mainly. Weight control and antiinflammatory and anti-edema diet are two additional necessary components of the holistic therapy in presence of primary or secondary limb lymphedema. This narrative review provides the available information derived from the scientific literature on nutrition in lymphedema, which anyway lacks robust evidence. Additional information and speculations are provided on the role of food, diet, nutraceuticals and fasting on the basic processes at the root of the chronic progressive degeneration of tissue lymph stasis, i.e. weight excess, inflammation, edema, fibroadiposis. More targeted and randomized studies are needed in order to assess and standardise the obvious, so far neglected, role of nutrition in lymphedema patients

The ICC Compression Questionnaire: A Comprehensive Tool to Evaluate Compression Materials or Devices Applied in Subjects with Lymphedema or Chronic Venous Disease

Background: Compression therapy is an important part of the treatment of patients with lymphedema or chronic venous disease. However, there is no validated questionnaire evaluating the effect of compression and its acceptance by the patient. Therefore, the aims of this study were to construct a questionnaire evaluating the effect of compression and its acceptance by the patient, that is, the Dutch ICC Compression Questionnaire (ICC-CQ), to investigate its reliability and validity, and to translate it into English. Methods and Results: Eleven experts in applying compression and 51 Dutch patients with experience of using compression were involved in the construction process. One part of the ICC-CQ has to be completed by the patient and evaluates seven domains. The other part has to be completed by the health care provider and comprises three domains. Reliability and validity of the final version was investigated in a new group of 79 Dutch-speaking patients with lymphedema or chronic venous disease, wearing compression garments (N = 52) or bandages (N = 27). Except for one domain, the Intraclass Correlation Coefficients for test-rest/interrater reliability ranged from 0.55 to 0.93. Cronbach's alpha for internal consistency ranged from 0.71 to 0.97. Eighty-nine percent of the patients fully understood the questionnaire indicating good face validity, and 87% found it complete indicating good content validity. Construct validity was considered good since 10 out of 11 hypotheses were accepted. Conclusion: The ICC-CQ is the first reliable and valid questionnaire evaluating different kinds of compression and the experience by patients with lymphedema or chronic venous disease

Maqui and Omega 3: effects on lipid profile, oxidative stress levels and psycho-physical items in human subjects

Aims: to assess short-term efficacy of supplementation with Maqui (Aristotelia Chilensis (Mol.Stuntz)), a polyphenol with antioxidant power, and EPA/DHA concerning metabolism, oxidative stress and mental/physical state. Patients and Methods: a pilot prospective observational clinical/laboratory study was performed on 17 apparently healthy subjects (8 males and 9 females, mean age 47 years). All subjects received for two months: a) Maqui 600 mg per day and b) 360 mg of EPA and 240 mg of DHA (salmon oil) daily. At day 0 and day 60 all subjects underwent nine laboratory tests related to inflammation, metabolism (lipid profile mainly) and oxidative stress parameters. Pre-post treatment weight and BMI was calculated. A few physical and mental parameters were assessed by means of Short-Form 12 questionnaire. Statistical analysis was applied to the resulting data through Wilcoxon test and t-paired test. Results: laboratory results before and after Maqui + EPA/DHA supplementation were respectively (mean and p-value for the comparison): total cholesterol 228.8/199.8 mg/dl, p=0.23; low density lipoproteins 127.4/122.1 mg/dl, p=0.13; high density lipoproteins 59.1/57.6 mg/dl, p=0.25; Reactive C Protein 0.18/0.09 mg/dl, p=0.32; triglycerides 106.1/91.1 mg/dl p=0.09, glycemia 92.9/92.8 mg/dl p= 0.92; total free radicals 338.0/303.6 U.Carr., p=0.002; serum anti-oxidant capacity 2075/2190 umol/l, p= 0.04; oxidized lipoproteins 641.8/553.1 uEq/l, p=0.10. SF12 physical and mental items (mean values and SD) were 51.2 (+/- 6.2) and 41.2 (+/- 3,3) at day 0 and 54.6 (+/- 11.6) and 47.2 (+/- 9.7) at day 60 respectively. One case of transient constipation was recorded. Conclusions: daily supplementation with Maqui 600 mg + Omega 3 fatty acids (EPA 360 mg + DHA 240 mg) in apparently healthy middle-aged subjects resulted in a statistically significant improvement of oxidative stress parameters. An overall (non statistically significant) improvement of dysmetabolism biomarkers was achieved. Mental and physical parameters have mildly improved

A phlebo-lymphology humanitarian trip to Matagalpa, Nicaragua

Amigos de Salud and Vene e Linfatici Foundation took part in a volunteer medical trip in Nicaragua. A detailed description of the provided healthcare is reported

Corrigendum to "European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. [Eur J Vasc Endovasc Surg (2022) 63, 184-267]"

proofepub_ahead_of_prin